By John Klimek, R.Ph., SVP of industry information technology, National Council for Prescription Drug Programs (NCPDP)

Momentum in electronic prescribing is

stronger than ever thanks to last year&#x2019;s boost from meaningful use. Physician incentives, payer-led initiatives and the drive toward interoperability are sure to make the technology pervasive in the outpatient setting over the next 36 months. NCPDP&#x2019;s SCRIPT standard, used in e-prescribing, has been around since 1997. Use of the standard by prescribers has been steadily on the rise, growing from 74,000 active prescribers in 2008 to 156,000 in 2009, and now up to more than 200,000 prescribers according to Surescripts, which operates a national e-prescribing network. Embedded in the meaningful-use (MU) requirements, e-prescribing adoption should jump sharply as physicians scramble to qualify for Stage 1 incentives for MU in 2011-2012. The Centers for Medicare and Medicaid Services (CMS)

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Alternative care-delivery models take root and grow

By Steve Schelhammer, president and CEO, Phytel

A crucial component of healthcare reform is to transform our care-delivery system to improve quality and control costs. To do that, the government is working with the private sector to test and promote new structures, such as the patient- centered medical home (PCMH) and the accountable care organization (ACO). Both of these innovations, which will gain momentum in 2011, require providers to make sure that everyone in their patient population is receiving appropriate preventive and chronic-disease care. Today, many physician practices and hospitals still operate in the traditional fee-for-service model. To build a successful medical home or ACO, providers will have to coordinate care and work with patients to improve their health. They will also have to track and monitor their patients&#x2019; health status and reach out to those patients who are noncompliant or have fallen out of touch with their physicians. In essence, they will be required to adopt a population health-management approach and

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and the Drug Enforcement Administration (DEA) have played a role in spurring physicians to adopt e-prescribing. CMS incentivized prescribers with a three-year, voluntary bonus program that began in January 2009 for successful e-prescribers; after 2012 CMS will begin instituting a penalty for failure to e-prescribe. And in May 2010, the DEA removed a chief barrier to adoption of e-prescribing with its rule permitting e-prescribing of controlled substances. From what we are hearing, the

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move to include the DEA requirements in e-prescribing tools by vendors is slow. Payer-driven initiatives will also fuel the surge in adoption

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by promoting care management, wellness and prevention programs and demanding data to support their quality and safety improvement initiatives. Some payers have even developed their own e-prescribing solutions to encourage adoption and lower costs. The drive toward interoperability requires EHR vendors to incorporate e-prescribing standards that will enable users to meet MU criteria, exchange health information and facilitate communication between prescribers and pharmacies. With no shortage of drivers, e-prescribing will hit the tipping point by 2014, enhancing quality, safety and cost effectiveness of care.

strategy. And more importantly, they will need automated capabilities in order to support these initiatives.

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Even with financial support from payers, physician practices cannot do this type of population health management without the aid of health information technology. Beyond electronic health records, they will need registries, multi-channel patient-messaging technologies, and Web-based tools for health- risk assessments and patient self-management

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education. Using registry-generated data to identify care gaps, physicians will be better able to deliver necessary services to patients when they visit, matching care-team skill sets to patient-specifi c needs. Similarly, care managers will use advanced population-based reporting and stratifi cation to identify patients who need personalized interventions and deliver automated methods to empower patients to become active participants in their own health. In the next year, we&#x2019;ll see the spread of these automation and care-coordination tools as alternative care-delivery models take root and grow. While experts say it will take some time before population health management becomes the norm, many healthcare leaders are already jumping on the bandwagon to take advantage of the incentives that Medicare and private insurers are offering.